Eye allergies affect roughly 10% of the U.S. population. Though some eye allergies are mild and seasonal, others can have severe results ending in permanently impaired vision or even blindness if not properly treated. Eye allergies may be the result of a few different causes and as such will have a few different treatments.

The conjunctiva plays an integral part in allergies. The conjunctiva, which is the membrane also responsible for nose allergy, eyes have as well. It is the mucus membrane which covers the white surface of the eyeball and inner folds of the eyelids. Irritants, allergens, or any other cause for allergic reaction usually will have to go through the conjunctiva first. This causes the release of histamine as a mediator. It is the release of histamine that can cause redness, itching, swelling, tearing and other symptoms.

Eye allergies, causes, and symptoms

Allergic conjunctivitis

This is one of the most common eye allergies. Conjunctivitis means the inflammation of the conjunctiva. It is usually seasonal and is caused by pollens although indoor irritants such as dust mites, pet dander, and molds may also be the cause. Symptoms can include redness, itching, burning, tearing, swelling of the eyelid, and a watery discharge.

Conjunctivitis with atopic dermatitis (also keratoconjunctivitis)

This is a more severe conjunctivitis. The causes are obviously similar to that of conjunctivitis but can also be potentially caused by food allergies. Symptoms include those of allergic conjunctivitis but more intense; intensely itchy eyes, heavy discharge, eyelids may develop scales or crusts, and in extreme cases the eyes experience a sensitivity to light.

In up to 10% of cases this can result in cataracts or in rare cases, blindness.

Vernal keratoconjunctivitis

Vernal keratoconjunctivitis is keratoconjunctivitis that occurs in the springtime (vernal refers to spring). Usually occurs in dry, dusty, windy, and warm climated rural areas. Symptoms include intense itch, light sensitivity, lids will feel uncomfortable or droopy, a stringy discharge, and a cobblestone effect under the eyelids.

Giant papillary conjunctivitis

Large bumps, papillae, form on the upper conjunctiva underneath the eyelids, hence the name. Often this is the result of a foreign substance, usually contact lenses. Whether the protein that can build up on the lenses, the lenses themselves, or the solution, it also causes itching of the eye and redness.

There are two main ways of dealing with eye allergies; avoidance and medication. With avoidance, take preventative measures such as cleaning your household of dust, dander, and mites. Avoid environments heavy in pollens and other irritants. Also try to wear wrap around sunglasses which can help prevent airborne irritants. It is important not to rub your eyes even though they may itch as this will irritate the mast cells furthering the effects. This can also lead to scarring of the cornea in severe cases. Moistening your eyes with artificial tears can also help as this can dilute allergens and prevent them from sticking to the conjunctiva. (obviously this is not the best solution for giant papillary conjunctivitis).

Medication alternatives may be required in some of the more intense cases. Antihistamines block histamine receptors in the eyes which will stop the itching but not the redness and swelling. Decongestants can prevent redness and swelling by shrinking blood vessels of the conjunctiva but not the itching. Obviously using these two in tandem can result in greater comfort by addressing the reactions. There are also topical anti-inflammatory drugs which can mostly be obtained by prescription. These are used in the most severe cases but should be only used at the doctor’s direction and taken with moderation and caution.

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